Disparities in Quality of Healthcare of Children from Immigrant Families in the US
Disparities in Quality of Healthcare of Children from Immigrant Families in the US
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DOI：
10.1007/s10995-015-1740-z
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发表时间：
2015-10-01
影响因子：
2.3
通讯作者：
Hawkins, Summer Sherburne
中科院分区：
文献类型：
--
作者：
Calvo, Rocio;Hawkins, Summer Sherburne
本研究的目的是探讨美国移民家庭儿童在儿科初级保健质量方面的差异。从2007年全国儿童健康调查的83，528名0-17岁儿童的全国代表性样本中抽取，使用加权logistic回归评估移民家庭类型对儿童种族/族裔群体医疗保健质量的五项指标的影响。分析控制了儿童获得护理的指标、家庭社会经济特征和家庭中使用的主要语言。未经调整的估计数显示，从移民子女到第二代子女（移民父母在本地出生的子女）和第三代子女（本地出生父母在本地出生的子女）的差距不断缩小。控制混杂因素表明，代际地位对移民家庭儿童医疗保健质量的积极影响在不同指标和种族/民族群体之间存在差异。即使是第三代西班牙裔和黑人儿童也没有达到与第三代白色儿童相同的水平，因为他们报告了提供者为他们提供护理的时间以及提供者对其家庭价值观和习俗的敏感性。相比之下，在调整混杂因素后，提供者仔细倾听照顾者的报告中的差异消失了，只有移民父母为首的家庭报告收到的具体健康相关信息少于本土出生的白色儿童的家庭。我们的研究表明，重要的是要制定干预措施，帮助医疗保健专业人员了解不同类型的移民家庭如何看待与医疗保健系统的互动，以及如何提供护理，提高来自不同种族/民族群体的儿童的满意度。
The objective of this study was to examine disparities in quality of pediatric primary care among children from immigrant families in the US. Drawing from a nationally representative sample of 83,528 children ages 0-17 years from the 2007 National Survey of Children's Health, weighted logistic regression was used to assess the effect of immigrant family type on five indicators of quality of healthcare across children's racial/ethnic groups. Analyses controlled for indicators of child's access to care, family socio-economic characteristics, and primary language spoken in the household. Unadjusted estimates revealed a pattern of decreasing disparities from immigrant children to second-generation children, native-born children of immigrant parents, and to third-generation children, native-born children of native-born parents. Controlling for confounders showed that the positive effect of generational status on the quality of healthcare of children from immigrant families varied across indicators and among racial/ethnic groups. Not even third-generation Hispanic and Black children reached parity with third-generation White children on reported amount of time that providers devoted to their care and on providers' sensitivity to their family's values and customs. In contrast, disparities in reports of providers listening carefully to caregivers disappeared after adjusting for confounders, and only families headed by immigrant parents reported receiving less specific health-related information than the families of native-born White children. Our study suggests that it is important to develop interventions that help healthcare professionals to learn how different types of immigrant families perceive the interactions with the healthcare system and how to deliver care that increases the satisfaction of children from different racial/ethnic groups.